Nursery service is an important part of ensuring and improving people's livelihood. At present, the demand of infant care service is strong in China, but the supply of infant care service is insufficient and needs to be standardized. From the experience of foreign countries, they have strict regulations and requirements on academic education, vocational training, professional qualifications, and other aspects of infant care service personnel. Therefore, the establishment of national vocational skills standards, the strengthening of professional construction and the integration of production and education, the inclusion of urgently needed vocational training programs, and the establishment of human resources database are conducive to promoting the professionalization of infant care service team.

2021 Vol. 29　(5):　864- [Abstract]（ 403 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To identify differential proteins expression and to study its corresponded pathways involved in the occurrences and development of glioblastoma (GBM) of female patients in different age groups by proteomic analysis of lesion after biopsies. Methods: A total of 18 female patients with GBM admitted to Guangdong Sanjiu brain hospital were selected as the research objects. The patients were divided into group A (patients aged <50 years old) and group B (patients aged ≥50 years old). Data independent acquisition (DIA) proteomics analysis was performed to study high-throughput proteomics of these 18 female patients, and the differentially expressed proteins in the tumor tissues of female patients with GBM in different age groups were screened. Functional enrichment analysis and protein interaction network analysis were performed.  Results: A total of 4617 proteins in the tumor tissues of these 18 female patients with GBM were identified, of which 3530 proteins were expressed in the tumor tissues of the patients in both groups. 99 proteins were differentially expressed in the tumor tissues of the patients in both groups by T test (P<0.05). The signaling pathways enrichment analysis showed that the proteins involved in the regulation of apoptosis and actin cytoskeleton of the patients in group B were up-regulated. The protein interaction networks analysis found that three potential key proteins were discovered to potentially regulate the progression of malignant GBM of the patients. Conclusion: Proteins differentially expresses in different age female patients with GBM. Alpha-1-acid glycoprotein 1, Annexin and Alpha-1-acid glycoprotein 2 may act as the key proteins to regulate the malignant proliferation of elderly female patients with GBM.

2021 Vol. 29　(5):　870- [Abstract]（ 350 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To investigate the acceptance status and cognitive level of cervical cancer and breast cancer (two cancers) of rural women from Haikou in recent 5 years, and to analyze the factors influencing of their screening behavior. Methods: 504 rural adult women in Haikou area were selected by stratified random sampling method. The basic information, the awareness of the knowledge about two cancers, the participation in two cancers screening, and the reasons for not participating in the screening were investigated by questionnaires and interviews. Results: The awareness rate of the knowledge about two cancers of the responders was 71.0%, which had decreased with the increase of the age of the responders, but had increased with the increase of their education level, and the awareness rate of responders with family history of two cancers was significant higher (P＜0.05). 53.0% responders had been accepted two cancers screening, and the percentage increased year by year in the past 5 years. The main reasons for not participating in the screening were " no need screening because of physical health " (22.4%), "no time" (18.1%), "not received  notice" (16.0%), "regular physical examination items without two cancers screening " (10.1%), and "no women around participation in two cancers screening " (9.7%). The main reasons for participating in the two cancer screening included "village cadres' organization" (67.0%), "concerned about their own health" (62.9%), “free screening " (33.0%), and " around women participation in two cancers screening " (28.1%). 80.0% of the responders could accept two cancers screening once a year and 75.0% of the responders were willing to bear part of the screening costs. The amount of those responders willing to bear the screening costs mainly ranged from ≤50 Yan (25.2%) to 51-100 Yuan (24.8%). The main reasons of the responder’s unwillingness to pay for the screening included "unnecessary" (7.9%), "high cost" (7.5%), and "poor economic conditions" (7.5%). Conclusion: The rate of two cancers screening of the rural women from Haikou has an increasing trend in recent five years, but the participation rate still needs to be improved. The cognitive level of knowledge about two cancers of the rural women is low. Although the necessity and willingness to pay for two cancers screening are high, their ability to actually pay for is low.

2021 Vol. 29　(5):　877- [Abstract]（ 358 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To analyze the effectiveness and safety of IN/DL-II type and IN/S type intrauterine devices (IUD) by ultrasound monitoring in different periods of women. Methods: 50 women who underwent induced abortion were selected in group A from January 2014 to January 2016, and were divided into group A1 and group A2 by random number table. The women in group A1 were inserted IN/DL-II type IUD immediately after abortion, and the women in group A2 were inserted IN/S type IUD immediately after abortion. Another 50 women who underwent IUD inserted 3-7 days after the end of menstruation or 6 months after abortion were selected in group B during the same period, and were divided into group B1 and group B2 by random number table. The women in group B1 were inserted IN/DL-II type IUD, and the women in group B2 were inserted IN/S type IUD. After 12 months followed up, the situation of IUD, the occurrence of side effects, and the bleeding within 3 months after IUD inserted of the women were compared among these groups. Results: 12 months after IUD inserted, there were no significant differences in the incidences of pregnancy with IUD, IUD removal for medical reasons, and complete discharge of IUD of the women among the four groups (P＞0.05). There was 1 woman with IUD discharge in group A1. In group A2, 1 woman was given IUD removed due to the distance between the perimetrium of and the upper edge of the IUD (S-S) ≤ 1.1cm in 2 months after IUD inserted. IUD of one woman was removed in group B1 and group B2. There were no significant differences in normal bleeding time and spot bleeding time of the women within 3 months after IUD inserted among the four groups (P＞0.05). The total bleeding time (22.1±2.3 d) of the women in group A2 was significant longer than that (20.1±2.3 d) of the women in group A1, and the total bleeding time (20.9±2.4d) of the women in group B2 was significant longer than that (19.2±2.1d) of the women in group B1 (all P<0.05). There were no significant differences in the incidences of increased menstrual volume, decreased menstrual volume, prolonged menstrual period, shortened menstrual cycle, waist and abdomen pain, irregular menstruation, and amenorrhea of the women among the four groups (P＞0.05). Conclusion: Fixed IUD inserted immediately after induced abortion, 3-7 days after the end of menstruation, or 1 month after abortion all has good effectiveness and safety, and the total bleeding volume of the women after IN/DL-II type IUD inserted is less than that of IN/S type IUD inserted.

2021 Vol. 29　(5):　885- [Abstract]（ 418 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To investigate the effects of butorphanol nasal spray and propofol for painless induced abortion. Methods: 160 women with ASA I-II who wanted painless induced abortion were randomly divided into two groups. The women in the observation group were given propofol for anesthesia, and butorphanol nasal spray (1mg) was given 10 minutes before operation. The women in the control group were given remifentanil (1.5μg/kg) combined with propofol anesthesia, and saline nasal spray was given 10 minutes before operation. The changes of heart rate (HR), mean arterial pressure (map), blood oxygen saturation (SpO2), anesthesia effect, total dosage of propofol, and postoperative visual analogue scale (VAS) before induction (T0), 2 minutes after induction (T1), and at the end of operation (T2), and adverse reactions of the women were compared between the two groups. Results: There were no significant differences in the percentages of mild limb activity without influencing operation technique (17.5% vs 20.0%), mild limb activity with influencing operation technique, agitation (3.8% vs 7.5%) during the operation, and anesthetic effect classification of the women between the two groups (P>0.05). The hemodynamics of the women in the observation group was significant more stable than that of the women in the control group, and the postoperative VAS score of the women in the observation group was significant lower. The total amount of propofol (85.3±20.2 mg) of the women in the observation group was significant lower than that (110.1±28.1 mg) of the women in the control group. The incidences of intraoperative bradycardia and respiratory depression (6.2 % and 12.5%) of the women in the observation group were significant lower than those (61.2% and 56.2%) of the women in the control group (P<0.05). Conclusion: Butorphanol nasal spray and propofol used in painless induced abortion has good analgesic effect with lower incidence of adverse reactions, which is more suitable for outpatient surgery than that of remifentanil.

2021 Vol. 29　(5):　895- [Abstract]（ 834 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To analyze the clinical effect of methotrexate (MTX) combined with uterine artery embolization (UAE) for treating cesarean scar pregnancy (CSP) of the women, and to study its influence on their subsequent pregnancy. Methods: 115 women with CSP were selected as study subjects, and were divided into group A (women used MTX) and group B (women used MTX combined with UAE) according to the principle of voluntary selection of the women from February 2013 to March 2017. The clinical efficacy, the ovarian function indexes, and the situation of subsequent pregnancy of the women were compared between groups. Results: The amount of blood loss during curettage (48.3±8.6 ml), the time of hospital stay (15.3±5.3 d), the time of blood β-HCG level returned to normal (20.4±7.8 d), and the time of mass disappearance (30.7±8.3 d) of the women in group B were significant lower than those of the women in group A (P＜0.05). There were no significant differences in the time of hysterectomy (30.7±9.5min vs 31.2±8.6min) and the incidence of complications (14.3% vs 11.5%) of the women between the two groups (P＞0.05). There were no significant differences in the serum levels of anti-Muller's tube hormone, follicle-stimulating hormone, luteinizing hormone, and estradiol, the clinical pregnancy rate, the duration of no contraception, and the rates of spontaneous abortion, recurrent CSP, and placental abnormality in 3 and 6 months after surgery of the women between the two groups (P＞0.05). Conclusion: The clinical efficacy of MTX combined with UAE for treating women with CSP is superior to MTX treatment alone without adverse effects on the subsequent pregnancy.

2021 Vol. 29　(5):　903- [Abstract]（ 356 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To study the effect of high-intensity ultrasound focused ultrasound (HIFU) for treating women with uterine myoma, and to analyze its influence on their levels of estrogen receptor(ER) and Bcl-2 gene (Bcl-2). Methods: From December 2016 to December 2018, 100 women with uterine myoma were included and divided into two groups based on different treatments. The women in the control group were treated with laparoscopic hysteromyomectomy, and the women in the observation group were given HIFU treatment. The clinical effect of the women in the two groups after treatment was analyzed. Results: The recovery time of voluntary activity (0.6±0.2d), hospitalization time (4.5±1.1d), and blood loss (0ml) of the women in the observation group were significant lower than those of the women in the control group (P<0.05). There were no significant differences in the levels of anti-Mushi tube hormone (AMH), follicle stimulating hormone(FSH), luteinizing hormone (LH), and estradiol(E2) of the women between the two groups (P>0.05). The positive expression of ER and Bcl-2 of the women had decreased significantly after operation (P<0.05), but which had no significant differences of the women between the two groups (P>0.05). The complication rate of the women in the observation group (36.0%) was significant lower than that (56.0%) of the women in the control group (P<0.05). Conclusion: HIFU used for treating women with uterine myoma has little influence on their ovarian function with the characteristics of less trauma, rapid recovery, and high safety.

2021 Vol. 29　(5):　911- [Abstract]（ 337 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

2021 Vol. 29　(5):　917- [Abstract]（ 311 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To explore the value of thromboelastogram (TEG) combined with five items of coagulation function for evaluating improvement of coagulation after low molecular weight heparin treatment of the women with severe preeclampsia. Methods: 120 pregnant women with severe preeclampsia were selected and were randomly divided into group A and group B (60 cases in each group) from January 2019 to December 2019. The women in group A were given routine treatment (such as spasmolysis, hypotension, sedation, dilatation, and diuresis) for 3-5 days. The women in Group B were given subcutaneous injection of 5000U of low molecular weight heparin every day except to the treatment in the control group for 3-5 days. In addition, 60 pregnant women were selected in control group during the same time. The five items of coagulation function (PT, APTT, TT, Fib, and D-Dimer) and TEG parameters of the women before and after treatment were compared between group A and B. Results: The values of PT, TT, and APTT, and the values of R and K of TEG of the women in group A and B were significant lower than those of the women in the control group, but the values of FIB, D-D, and the values of α angle, MA, and CI of TEG of the women in group A and B were significant higher than those of the women in the control group (all P＜0.05). There were no significant differences in the five items of coagulation function and TEG parameters of the women between group A and B (P＞0.05). Compared with those before treatment, the values of PT, TT and APTT of the women after treatment in group A and B had increased significantly, the values of their FIB and D-D had decreased significantly, the values of their R and K values of TEG had increased significantly, and the values of their α Angle, MA and CI of TEG had decreased significantly (all P <0.05). After treatment, the values of PT and TT of the women in group B were significant higher than those of the women in group A, and D-D value of the women in group B was significant lower than that of the women in group A (all P＜0.05). There were no significant differences in APTT and FIB values of the women between group A and B (P＞0.05). The values of R and K of the women in group B were significant higher than those of the women in group A, but the values of α Angle, MA, and CI of TEG of the women in group B were significant lower (all P＜0.05). Conclusion: TEG used for evaluating the improvement of coagulation function after low molecular weight heparin treatment of the women with severe preeclampsia is better than that of five items of coagulation function, which suggests that TEG can be used as a testing method to evaluate coagulation function of the women with severe preeclampsia.

2021 Vol. 29　(5):　926- [Abstract]（ 451 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To investigate the relationship between the levels of serum C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), fetal fibronectin (FFN), platelet activating factor (PAF) of the pregnant women with hypothyroidism and the preterm delivery occurrence. Methods: 151 pregnant women with hypothyroidism were enrolled in observation group and 120 healthy pregnant women were enrolled in control group from January 2018 to January 2019. The levels of CRP, NLR, FFN and PAF of the women during the 28th gestational week were measured and were compared between the two groups. In the observation group, there were 46 women with preterm delivery in group A and 105 women without preterm delivery in group B. Logistic regression was used to analyze the factors affecting preterm delivery of the pregnant women with hypothyroidism. Results: The serum levels of CRP (8.86±2.31 mg/L), NLR (4.36±1.28), FFN (40.51±6.51 ng/ml) and PAF (2.89±0.55 ng/ml) of the women in the observation group were significant higher than those (5.14±1.66 mg/L, 1.77±0.53, 28.66±4.49 ng/ml, and 2.03±0.27 ng/ml) of the women in the control group (P＜0.05). Increase of age, vaginitis, cervix shortening, high levels of serum CRP, NLR, FFN and PAF were the independent risk factors of preterm delivery of the pregnant women with hypothyroidism (P＜0.05). Conclusion: The levels of serum CRP, NLR, PAF and fFN of the pregnant women with hypothyroidism increase significantly, and the high levels of which are the independent risk factors affecting their preterm delivery occurrence.

2021 Vol. 29　(5):　935- [Abstract]（ 443 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To investigate the relationship between the grade of cervical intraepithelial neoplasia (CIN) of pregnancy women with HPV infection and their adverse pregnancy outcomes. Methods: 60 pregnant women with CIN II were enrolled in group A or women with CIN III in group B, and 50 healthy pregnant women were enrolled in control group from January 2016 to January 2019. HPV infection of the women in the groups was detected, and adverse pregnancy outcomes of the women were analyzed. Results: The positive rate of HPV of the women in group A (72.4%) had no significant different from that (87.1%) of the women in group B, which both was significant higher than that (12.0%) of the women in the control group (P＜0.05). The rate of HPV turned to negative (33.3%) of the women in group A was significant higher than that (7.4%) of the women in group B (P＜0.05). The HPV load (354.15±41.13 pg/ml) of the women in group A was significant lower than that (427.54±44.36 pg/ml) of the women in group B, and which of the women in both group A and B in postpartum 6 months was significant lower than that that of the women in both group A and B during pregnancy. The HPV load (161.12±30.25 pg/ml) of the women in group A during pregnancy was significant lower than that (235.16±31.54 pg/ml) of the women in group B (P＜0.05). The rates of adverse pregnancy outcomes of the women with HPV infection and their adverse perinatal infant outcomes were 20.8% and 10.4%, which had no significant different from those (8.3% and 8.3%) of the women without HPV infection (P＞0.05). The incidence of adverse pregnancy outcomes of the women in group B was significant higher than that of the women in the control group (P＞0.05). Conclusion: HPV infection rate of the women with CIN II or III during pregnancy is higher, and with the increase of CIN grade of the women, their HPV infection rate is increasing and the negative conversion ratio of postpartum HPV is decreasing. It suggests that HPV infection may promote the development of CIN and cervical cancer, and improve their adverse pregnancy outcomes, therefore it should be advocated to HPV infection screening of women before pregnancy, which has certain value for improving the pregnancy outcomes.

2021 Vol. 29　(5):　943- [Abstract]（ 357 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To investigate the effect of recombinant human interferon-α2b (rhIFN-α2b) combined with sodium citrate sodium chloride for treating cervical human papillomavirus (HPV) continuous infection of the women. Methods: 134 women with cervical HPV infection were randomly divided into study group and control group (67 cases in each group) by random number table from March 2016 to October 2018. The women in the two groups were treated with rhIFN-α2b for 3 months, and the women in the study group were treated with citrate sodium chloride additionally. The Th1/Th2 cytokines level, HPV-DNA load, cervical inflammatory score, and clinical efficacy of the women in the two groups were compared before and after treatment. Results: After treatment, the serum levels of IL-2 (75.05±8.96 pg/ml), IFN-γ(1.03±0.26 pg/ml), IL-10 (23.07±4.77 pg/ml), IL-4 (36.09±6.36 pg/ml), HPV-DNA load (1.60±0.63 log10 copies/l), and cervical inflammatory score (1.3±0.6 points) of the women in the study group were significant lower than those of the women in the control group, and the clinical efficacy of the women in the study group was significant better (all P＜0.05). Conclusion: The effect of rhIFN-α2b combined with sodium citrate sodium chloride for treating cervical HPV continuous infection is superior to that of rhIFN-α2b used only.

2021 Vol. 29　(5):　952- [Abstract]（ 377 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the effect of health education on negative emotions, self-efficacy, and the rate of continuing pregnancy in women with early threatened abortion. Methods: 120 women with early threatened abortion were selected and divided into group A (60 women with health education and routine nursing) and group B (60 women with routine nursing) according to different nursing treatment. The scores of negative emotions by self-rating anxiety scale (SAS) and self-rating depression scale (SDS), self-efficacy, clinical efficacy, nursing satisfaction, and the success rate of pregnancy protection of the women were compared between the two groups. Results: After intervention, the SAS score and SDS score of the women in both groups had decreased significantly, and which (34.2±3.0 points and 37.1±3.0 points) of the women in group A were significant lower than those (44.4±3.4 points and 43.6±3.7 points) of the women in group B, GSES score of the women in both groups had increased significantly, and which (35.4±3.6 points) of the women in group A was significant higher than that (28.3±2.6 points) of the women in group B (all P＜0.05). The success rate (85.0%) of pregnancy protection, treatment effective rate (93.3%), and nursing satisfaction (96.7%) of the women in group A were significant higher than those (66.7%, 71.7%, and 81.7%) of the women in group B (all P＜0.05). Conclusion: Health education for the women with early threatened abortion can effectively improve their depression, anxiety, and other negative emotions, can enhance self-efficacy, nursing satisfaction, and the rate of continuing pregnancy.

2021 Vol. 29　(5):　960- [Abstract]（ 322 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To explore the effect of sequential treatment of estradiol valerate combined with medroxyprogesterone in the recovery of women with multiple induced abortions. Methods: 167 women with multiple induced abortions were included and were divided into observation group and control group between July 2018 and July 2019. After abortion, 83 women in the control group were treated with conventional therapy, such as antiphlogosis and promoting uterine contraction, and 84 women in the observation group were treated with estradiol valerate combined with medroxyprogesterone except to the conventional therapy. After treatment, the postoperative vaginal bleeding time, uterine adhesion incidence, endometrial thickness, menstrual recovery time, and the uterine hemodynamic indicators, such as resistance index (RI), pulsatility index (PI), the ratio of the end-systolic peak, and the end-diastolic peak blood flow of the intimal spiral artery (S/D) of the women were compared between the two groups. Results: The incidence of intrauterine adhesions (13.1%) of the women in the observation group was significant lower than that (33.7%) of the women in the control group, and the postoperative vaginal bleeding time (6.2±1.3d) and menstrual recovery time (31.2±3.4d) of the women in the observation group were significant shorter than those (7.9±1.3d and 36.9±3.8 d) of the women in the control group (P＜0.05). The endometrial thickness (8.74±0.98mm) of the women in the observation group was significant greater than that (7.18±1.04mm) of the women in the control group, but the values of RI, PI and S/D of the women in the observation group were significant lower. The complication rate (16.7%) of the women in the observation group was significant lower than that (41.0%) of the women in the control group (P＜0.05). Conclusion: Sequential treatment by estradiol valerate combined with medroxyprogesterone for women with multiple induced abortions has better effect, which can promote the recovery of their uterine physiological function, improve their uterine blood supply and endometrial recovery.

2021 Vol. 29　(5):　968- [Abstract]（ 950 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To analyze the difference of vaginal microecological characteristics of the infertile patients with repeated embryo transfer failure and the infertile patients with successful embryo transfer for the first time. Methods: 77 infertile patients with repeated embryo transfer failure were selected in observation group from February 2016 to October 2019, and 80 infertile patients with successful embryo transfer for the first time were selected in control group during the same period. The differences of vaginal microecological morphology and functional characteristics of the patients were compared between the two groups. Results: The vaginal secretion flora diversity (grade I and IV), flora density (grade I and IV), and the positive rate of trichomonal test of the patients in the observation group were significant higher than those of the patients in the control group (P＜0.05), but there was no significant difference in fungal detection result of the patients between the two groups (P＞0.05). The proportion of the patients with lactobacillus as dominant bacteria and the Nugent score of the patients in the observation group were significant lower than those of the patients in the control group. The percentage of patients with vaginal PH >4.6, leukocyte esterase positive, acetylglucosaminidase positive, sialidase positive, and β-glucuronidase positive of vaginal secretion, and the level of hydrogen peroxide in vaginal secretion of the patients in the observation group were significant higher than those of the patients in the control group. The proportion of vaginal microecological dysregulation (55.8%) of the patients in the observation group was significant higher than that (13.8%) of the patients in the control group (all P＜0.05). The detection rates of intermediate type BV, BV, AV and TV of the patients in the observation group were significant higher than those of the patients in the control group (P＜0.05), but there was no significant difference in the detection rates of VVC, BV+VVC, and intermediate type BV and VVC of the patients between the two groups (P＞0.05). Conclusion: The infertility patients with repeated failure of embryo transfer have the microecological imbalance of vaginal flora, so the analysis of vaginal microflora of the infertile patients should be strengthened, and targeted treatment measures should be taken to correct their vaginal microecological imbalance in clinical practice, so as to improve the success rate of thawing embryo transfer.

2021 Vol. 29　(5):　976- [Abstract]（ 342 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To explore the influencing factors of the effect of oocyte resuscitation of mature oocytes cryopreservation in infertile women, and to provide evidences for clinical decision-making. Methods: The clinical data of 2691 mature oocytes from the women with infertile caused by their husbands were retrospectively analyzed. According to the survival situation after oocyte resuscitation, these cryopreservation oocytes were divided into 2003 survival oocytes and 688 non-survival oocytes. According to age, these oocytes of the women were divided 2297 oocytes of the women <35 years old and 394 oocytes of the women ≥35 years old. Univariate and multivariate logistic regression analysis were applied to explore the risk factors of affecting oocyte thawing. Results: The survival rate of cryopreservation oocytes after resuscitation was 74.4% (2003/2691). Advanced age (OR=0.94, 95%CI 0.91-0.97), less antral follicles (OR=1.03, 95%CI 1.01-1.04), and endometriosis (OR=0.68, 95%CI 0.49-0.95) were the independent risk factors affecting oocyte thawing of women under 35 years old. For women ≥35 years old, basal estradiol level (OR=0.98, 95%CI 0.98-0.99), prolonged cryopreservation time (OR=0.98, 95%CI 0.97-0.99), endometriosis (OR=0.15, 95%CI 0.06-0.36), and secondary infertility (OR=0.22, 95%CI 0.13-0.37) were the independent risk factors affecting oocyte thawing. Conclusion: Age is the key factor affecting the resuscitation of human mature oocytes after cryopreservation. The factors affecting the resuscitation of human mature oocytes after cryopreservation of the women with different ages are different. Before 35 years old, the risk of oocyte thawing failure of thewomen increased significantly with the increase of age, with the decrease of antral follicles, and with the occurrence of endometriosis. For women≥35 years old, elevated basal estradiol level, prolonged cryopreservation time, and endometriosis were the key risk factors for oocyte thawing failure.

2021 Vol. 29　(5):　983- [Abstract]（ 318 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

AbstractObjective: To analyze the clinical effect of loop electrosurgical excision procedure (LEEP) for treating women with cervical intraepithelial neoplasia (CIN) who wanted fertility preserving, and to study its effect on their pregnancy outcomes. Method: The clinical data of 200 women with CIN from January 2017 to January 2018 were analyzed retrospectively. These women were divided into group A (97 women with 15-20mm depth of LEEP resection) and group B (103 women with 21-25mm depth of LEEP resection). During the same time, 98 healthy women were selected in group C. The rates of postoperative cervical healing, cervical stenosis, and complication, and quality of life of the women were compared among the three groups. Results: The rate of complete cervical healing (88.7%) of the women in group A was significant higher than that (71.8%) of the women in group B, the rate of severe cervical stenosis (5.2%) of the women in group A was significant lower than that (22.3%) of the women in group B, and the incidence of complication (10.3%) of the women in group A was significant lower than that (32.0%) of the women in group B. The postoperative quality of life, health status, and the scores of physiological, psychological and social relationship scores of the women in group A were significant higher than those of the women in group B (all P＜0.05). There were no significant differences in the gestational weeks when delivery, birth weight of newborn, the rates of fetal distress, abnormal amniotic fluid volume, placenta previa, cervical laceration, and low birth weight, and so on of the women among the three groups (P＞0.05). The amniotic fluid volume of the women in group A and B had no significant different (P＞0.05), but the rates of preterm premature (26.1% and 24.3%), the rupture of membranes (30.4% and 21.6%), and the cesarean section rate (8.7% and 8.1%) of the women in group A and B were significant higher than those (3.0%, 3.0%, and 6.1%) of the women in group C (P＜0.05). Conclusion: LEEP treatment can increase the incidences of premature delivery, premature rupture of membranes, and cesarean section of the women with CIN who wanting fertility function reserve. When the resection depth is 15-20mm, it is more conducive to cervical repair and the quality of life improvement with higher safety. It is feasible to carry out LEEP under controlling the depth of resection strictly.

2021 Vol. 29　(5):　992- [Abstract]（ 356 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To analyze the correlation of the level of serum Clq/tumor necrosis factor-related protein 9 (CTRP9) of women with polycystic ovary syndrome (PCOS) with their levels of glucose and lipid metabolism and total testosterone (TT), body mass index (BMI) value, and islet function. Methods: 103 women with PCOS were selected in study group from January 2019 to December 2019, and 103 healthy women were selected in control group during the same period. The levels of serum CTRP9, glucose and lipid metabolism, and TT, BMI value, and islet function of the women were compared between the two groups, and its effect on PCOS and the correlation of the serum CTRP9 level with the levels of glucose and lipid metabolism, and TT, BMI value, and islet function were analyzed. Results: The serum CTRP9 and high-density lipoprotein cholesterol (HDL-C) levels of the women in the study group were significant lower than those of the women in the control group (P＜0.05). The levels of serum fasting blood glucose (FPG), 2h postprandial blood glucose (2hPBG), triacylglycerol (TG), lowdensity lipoprotein cholesterol (LDL-C), free fatty acids (FFA), TT, and fasting insulin (FINS), and the values of BMI, pancreatic β-cell secretion index (HOMAβ), and steady state insulin evaluation index (HOMA-IR) of the women in the study group were significant higher than those of the women in the control group (P＜0.05). According to Pearson analysis had showed that the level of serum CTRP9 was positive correlated with HDL-C level, but was negative correlated with the FPG level, 2hPBG level, TG level, LDL-C level, FFA level, BMI value, TT level, FIN level, HOMA-IR value, or HOMA-βvalue were correlated (P＜0.05). Multi-factor analysis had showed that FPG level, 2hPBG level, TG level, LDL-C level, FFA level, BMI value, TT level, FIN level, HOMA-IR value, HOMA-βvalue were all the risk affecting factors of PCOS, and CTRP9 level and HDL-C level were the protective factors of PCOS. Conclusion: The blood glucose level of the women with PCOS increases, their lipid metabolism disorders, their TT level and BMI value increase, and their pancreatic islet function disorder, which all will lead to the decrease of serum CTRP9 level and affect the disease process of PCOS.

2021 Vol. 29　(5):　1000- [Abstract]（ 809 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To analyze the changes of ultrasonic parameters of renal blood flow of pregnant women with different severity of preeclampsia (PE), and to study its correlation with their serum oxidative stress indicator. Methods: 77 pregnant women with PE were selected and divided into group A (49 women without severe PE) and group B (28 women with severe PE) from January 2017 to December 2019. The renal artery resistance index (RI), pulse index (PI), peak systolic velocity/peak end-diastolic velocity (S/D), renal vascular index (VI), blood flow index (FI), and blood vessel flow index (VFI) of the women in the two groups were detected by two-dimensional and three-dimensional energy Doppler ultrasound. Serum levels of malondialdehyde (MDA), advanced protein oxidation products (AOPPs), lipid hydrogen peroxide (LHP) and total antioxidant capacity (T-AOC) of the women were detected by ELISA and were compared between the two groups. The correlation between ultrasonic parameters of renal blood flow and the levels of serum oxidative stress indicators was analyzed. Results: The values of RI, PI and S/D of renal artery of the women in group B were significant higher than those of the women in group A, while the values of VI, FI and VFI of the women in group B were significant lower (all P＜0.05). The serum MDA, AOPPs and LHP levels of the women in group B were significant higher than those of the women in group A, but the serum T-AOC level of the women in group B was significant lower (all P＜0.05). The serum levels of MDA, AOPPs and LHP were positive correlated with the RI value of renal artery (P＜0.001), and the T-AOC level was negative correlated with the RI value of renal artery (P＜0.05). The level of AOPPs was positive correlated with the PI value of renal artery (P＜0.05), and the T-AOC level was negative correlated with the S/D value of renal artery (P＜0.05). The MDA and LHP levels was no correlation with the values of RI and S/D of renal artery, and the serum T-AOC level was no correlation with PI value of renal artery (all P＞0.05). The serum MDA, AOPPs and LHP levels were negative correlated with the FI and VFI values of renal artery, while the T-AOC level was positive correlated with the FI and VFI values of renal artery (all P＜0.05). There was a negative correlation between the AOPPs level and the VI value of renal artery (P＜0.05), but there was no correlation between the levels of MDA, LHP and T-AOC and the VI value of renal artery (all P＞0.05). Conclusion: The abnormal oxidative stress indicator of the pregnant women with PE is related to the decrease of their renal blood perfusion, which is expected to be a reference index for evaluating their renal injury.

2021 Vol. 29　(5):　1008- [Abstract]（ 349 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To explore the value of serum free fatty acid (FFA), pregnancy-associated plasma protein A (PAPP-A), kidney injury molecule -1 (Kim-1), and neutrophil gelatinase-associated lipocalin (NGAL) of women with gestational diabetes mellitus (GDM) for diagnosing their early impaired renal function. Methods: 124 pregnant women with GDM were divided into group A (83 women with normal renal function) and group B (41 women with impaired renal function) according to their endogenous creatinine clearance rate (Ccr) value from January 2019 to January 2020. In addition, 60 healthy pregnant women were selected in group C during the same period. The levels of serum FFA, PAPP-A, Kim-1, and NGAL of the women in the three groups were observed, and their value for diagnosing early renal function injury of the women with GDM was analyzed. Results: The serum FFA, KIM-1 and NGAL levels of the women in group B were significant higher than those of the women in group A, and which both in group B and in group A were significant higher than those of the women in group C. The serum PAPP-A level of the women in group B was significant lower than that of the women in group A, and which both in group B and in group A was significant higher than that of the women in group C (P＜0.05). The FFA level was positive correlated with the KIM-1 and NGAL levels (r=0.674, 0.712, P＜0.01), and which was negative correlated with the PAPP-A level (r=-0.648, P＜0.01). The level of PAPP-A was negative correlated with the levels of KIM-1 and NGAL (r=-0.711, 0.754, P＜0.01), and the level of KIM-1 was positive correlated with the level of NGAL (r=0.731, P＜0.01). The optimal cut-off value of the FFA level, the PAPP-A level, the KIM-1 level, or the NGAL level for diagnosing early impaired renal function of the women with GDM was >1.2mmol/L, ≤4.5U/L, ≥7.0 ng/mL, or >55.9 ug/L, which’s sensitivity was 74.5%, 85.1%, 78.4%, or 87.1%, which’s specificity was 86.4%, 87.2%, 95.6%, or 87.1%, and which’s AUC was 0.840, 0.901, 0.887, or 0.891. The value of serum FFA level, Kim-1 level or NGAL level for diagnosing early impaired renal function of the women with GDM was significantly higher than that of the FFA level. Conclusion: Serum FFA, PAPP-A, Kim-1 and NGAL levels are helpful to the clinical screening early impaired renal function of the women with GDM, especially PAPP-A, Kim-1 and NGAL levels have higher sensitivity and specificity.

2021 Vol. 29　(5):　1016- [Abstract]（ 336 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To observe the expression of glucose transporter (GLUT), insulin signal transduction protein (IRS), and sex hormone binding globulin (SHBG) in placental tissues of pregnant women with gestational diabetes mellitus (GDM)，and to study the relationship between the GLUT, IRS and SHBG levels in placental tissues of pregnant women and their GDM occurrence. Methods: 42 pregnant women with GDM and cesarean section were selected in study group from December 2008 to December 2018，and 42 healthy pregnant women were selected in control group during the same period. The expression of GLUT, IRS and SHBG in placenta tissue of the women in the two groups were detected，and which’s clinical significances were analyzed. Results: The levels of fasting blood glucose and 2h blood glucose of OGTT of the women, and neonatal weight in study group were all significant higher than those of the women in the control group, but the levels of GLUT-3, GLUT-4, IRS-2, P13K p85α, and SHBG mRNA in the placenta of the women in the study group were significant lower than those of the women in the control group (all P＜0.05). Pearson analysis showed that SHBG level was positive correlated with the levels of GLUT-3, GLUT-4, IRS-2, and P13K P85α mRNA, and IRS-2 level was positive correlated with GLUT-1 and GLUT-4 mRNA levels. IRS-1 level was negative correlated with GLUT-3 and P13K P85α mRNA levels, and SHBG level was positive correlated with GLUT-3, GLUT-4, and IRS-2 protein levels, and IRS-2 level was positive correlated with GLUT-3 and GLUT-4 levels. IRS-1 level was negative correlated with GLUT-3 protein level. Conclusion: The decrease of SHBG of pregnant women with GDM leads to the disorder of sex hormone metabolism and decrease of glucose metabolism, and further leads to insulin resistance. When the SHBG level of pregnant women with GDM has reduced, the related molecular levels of insulin signal transduction pathway also change, thus reduce the uptake and utilization of glucose in the placenta, and cause GDM occurrence eventually.

2021 Vol. 29　(5):　1025- [Abstract]（ 403 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To investigate the expression characteristics of adipocytokines and inflammatory factors of the women with gestational diabetes mellitus (GDM) during pregnancy and puerperium. Methods: 265 pregnant women with GDM were selected in study group and 200 normal pregnant women were selected in control group from October 2019 to October 2020. The adipocytokines and inflammatory factors of the women in the two groups were detected during pregnancy and puerperium, and their correlation with the insulin resistance index (HOMA-IR) was analyzed. Results: The levels of serum CRP, TNF-α, IL-6, and HOMA-IR of the women during pregnancy in the study group were significant higher than those of the women in the control group (P＜0.05). The serum levels of TNF-α, IL-6 and HOMA-IR of the women in the study group had showed a downward trend, while their CRP level had showed upward trend and then downward trend. The serum levels of CRP, TNF-α, IL-6, and HOMA-IR of the women in the study group were significant different during pregnancy, on the postpartum 3rd day, and on the postpartum 42th day (P＜0.05). Compared with those of the women in the control group, the adiponectin level of the women in the study group during pregnancy was significant lower, and the levels of leptin and vaspin were significant higher. The adiponectin level of women during pregnancy, on the postpartum 3rd day, and on the postpartum 42th day had showed downward an upward trend, while the levels of leptin and Vaspin had showed downward trend (all P＜0.05). Correlation analysis showed that the adiponectin level of the women with GDM during pregnancy was negative correlated with their HOMA-IR value, while the levels of leptin, vaspin, CRP, TNF-α, and IL-6 were positive correlated with their HOMA-IR value (all P＜0.05). The adiponectin level of the women with GDM on the postpartum 3rd day and the 42th day was also negative correlated with their HOMA-IR value, and the levels of leptin, vaspin, CRP, TNF-α, and IL-6 were positive correlated with their HOMA-IR value (all P＜0.05), but there was no significant correlation between the CRP level and the HOMA-IR value (P＞0.05). Conclusion: The adipocytokines and inflammatory factors are involved in the pathophysiological process of GDM, and their levels are closely related to the degree of insulin resistance of the women during puerperium, which has some value for predicting postpartum insulin resistance.

2021 Vol. 29　(5):　1032- [Abstract]（ 315 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To explore the effect of group B streptococcus (GBS) infection of women during pregnancy on premature rupture of membranes and neonates, and to study drug sensitivity. Methods: 1266 pregnant women who had received GBS screening were enrolled in this study from January 2018 to August 2018, and which included 220 women with premature rupture of membranes in observation group and 1046 women without premature rupture in control group. The detection result of GBS and neonatal outcomes were compared between the two groups. In addition, anti-infection intervention was given the women in the observation group. Results: The positive rate of GBS (12.3%) of the women in the observation group was significant higher than that (5.5%) of the women in the control group. The rates of premature rupture of membranes, puerperal infection, intrauterine infection, postpartum hemorrhage, and other adverse pregnancy of 85 women with GBS infection were significant higher than those of 1181 women without GBS infection. The total incidence (neonatal infection, fetal distress, neonatal asphyxia, and pneumonia of newborn) of the women with GBS infection (23.5%) was significant higher than that (8.8%) of the women without GBS infection. The neonatal Apgar score 1 min and 5 min after born (7.0±0.8 points, 8.4±1.7) of the women with GBS infection were significant lower than those (8.2±1.3 points and 9.0±2.0 points) of the women without GBS infection (all P＜0.05). The results of drug sensitivity test of the women with GBS infection showed that penicillin (95.3%) and cephalosporin (91.8%) were more sensitive, while clindamycin (72.9%) and amikacin (70.6%) were less sensitive. After nursing intervention, the satisfaction of the women with GBS infection was 100%. Conclusion: GBS infection of the women during pregnancy will increase the risk of neonatal adverse events and premature rupture of membranes. Therefore, drug sensitivity test should be performed immediately after the diagnosis of pregnant women infection, and targeted antibiotics treatment and nursing intervention should be selected for reducing the incidence of premature rupture of membranes, so as to improve the adverse outcomes of mothers and infants.

2021 Vol. 29　(5):　1041- [Abstract]（ 413 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To explore the value of single beat real-time three-dimensional echocardiography (sRT-3DE) for screening fetal congenital heart disease (CHD).  Methods: The clinical data of 4,786 pregnant women who underwent prenatal ultrasound examination from January to December 2019 were analyzed retrospectively. All women had accepted two-dimensional echocardiography (2DE) and sRT-3DE. The pregnant women with suspected fetal CHD were followed up. The followed up result (autopsy pathology after labor induction or postpartum ultrasound examination of infants) was as the golden standard. The diagnostic value of prenatal 2DE and sRT-3DE for fetal CHD was evaluated by Kappa consistency test.  Results: There were 46 (1.0%) pregnant women with suspected fetal CHD by prenatal 2DE or sRT-3DE. Among them, there were 44 (95.7%) women with completely consistent results of prenatal sRT-3DE and followed up, and 2 (4.4%) women with suspected fetal ventricular septal defect (VSD) were confirmed that their fetus without continuous interruption of ventricular septum after birth. There were 33 (71.7%) women had completely consistent results by prenatal 2DE and by followed up. The diagnostic coincidence rate of completely consistent results by sRT-3DE was significant higher than that by 2DE (P＜0.05). The diagnostic consistency for fetal CHD was good between prenatal 2DE result and followed up result (Kappa=0.834), which’s sensitivity, specificity, and accuracy were 75.0%, 99.9%, and 99.7%, respectively. The diagnostic consistency for fetal CHD was good between prenatal sRT-3DE result and followed up result (Kappa=0. 978), which’s sensitivity, specificity, and accuracy were 100.0%, 99.9%, and 99.9%, respectively. Conclusion:  sRT-3DE can improve the detection rate of CHD in the prenatal diagnosis, with higher diagnostic efficiency.

2021 Vol. 29　(5):　1050- [Abstract]（ 397 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To investigate the relationship between miR-122-5p level of patients and their clinicopathological features of epithelial ovarian cancer (EOC), and to study its value for predicting the postoperative prognosis of the patients. Methods: 118 patients with EOC underwent surgery were selected as research subject during August 2014 and August 2017, and the expression level of miR-122-5p in tumor tissues and adjacent tissues of the patients was compared. According to the situation of postoperative followed up, the patients were divided into group A1 (49 death patients) and group A2 (69 survival patients), and the expression differences of miR-122-5p in tumor tissues of the patients were compared between the two groups, and the value of miR-122-5p level for predicting postoperative survival of the patients with EOC was analyzed by receiver operating characteristic (ROC) curve. According to the optimal cutoff value of ROC curve, the patients with EOC were divided into group B1 (64 patients with high expression of miR-122-5p) and group B2 (54 patients with low expression of miR-122-5p), and the survival differences of the patients was compare between group B1 and B2. The clinicopathological characteristics of the patients with different miR-122-5p expression were analyzed, and the influencing factors of postoperative survival outcomes were analyzed by multivariate Cox regression model. Results: The miR-122-5p level in tumor tissues (0.31±0.08) was significant lower than that (0.40±0.11) in adjacent normal tissues. The level of miR-122-5p in tumor tissues of the patients in group A1 (0.26±0.06) was significant lower than that (0.34±0.11) of the patients in group A2 (P＜0.05). ROC curve showed that the optimal cutoff value of miR-122-5p expression level in tumor tissue of the patients for predicting postoperative death rate during the followed up period was 0.30, and the AUC was 0.808 (95%CI,0.7388-0.891), with the sensitivity of 68.1% and the specificity of 75.5%. Kaplan-Meier survival curve showed that the postoperative survival outcomes of the patients in group B1 was significant better than that of the patients in group B2 (P＜0.05). Cox regression analysis showed that miR-122-5p level ≤0.30, FIGO Ⅲ stage, and complicated lymph node metastasis were the independent risk factors of postoperative death of patients with EOC (P＜0.05). Conclusion: Expression level of miR-122-5p in tumor tissue of the patients with EOC is closely related to their clinicopathological characteristics, and the decrease or even loss of miR-122-5p expression may contribute to predict the occurrence of poor postoperative prognosis of the patients with EOC.

2021 Vol. 29　(5):　1058- [Abstract]（ 824 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To study the diagnostic value of prenatal ultrasound for fetal abdominal cystic masses. Methods：59 pregnant women with fetal abdominal cystic masses found by prenatal ultrasound between December 2017 and December 2019 were included as objects of this study. The results of prenatal ultrasound examination and the results of postpartum examination or anatomy of fetus after induction of labor were compared. The diagnostic value of prenatal ultrasound for fetal abdominal cystic masses was analyzed. Results：Among 59 pregnant women with fetal abdominal cystic masses diagnosed by prenatal ultrasound, 55 women with fetal abdominal cystic masses were confirmed by postpartum examination or fetal anatomy after induction of labor. The misdiagnosis rate and accuracy rate of prenatal ultrasound for fetal abdominal cystic masses were 5.1% (4/59) and 94.9% (55/59). The abdominal cystic masses of 55 fetuses were derived from the liver, biliary tract, reproductive system, digestive tract, and urinary system. Among 4 misdiagnosis cases, 1 case of misdiagnosed cystic mass derived from biliary tract by prenatal ultrasound actually was biliary atresia, and 2 cases of misdiagnosed cystic mass derived from digestive tract by prenatal ultrasound were actually congenital megacolon, 1 case misdiagnosed cystic mass derived from digestive tract by prenatal ultrasound actually was actually annular pancreas, and 1 case of misdiagnosed cystic mass derived from urinary system by prenatal ultrasound was actually mesenteric cyst. In 55 cases of fetal abdominal cystic masses, 15 cases occurred in the upper abdomen and 5 cases was choledochocyst, 31 cases occurred in retroperitoneum and 22 cases was hydronephrosis, 13 cases occurred in lower abdomen and 9 cases were ovarian cyst. Conclusion: Prenatal ultrasound can effectively detect the fetal abdominal cystic masses with certain misdiagnose rate. It is suggested that clinicians should pay more attention to the source of the fetal abdominal cystic masses which may lead to misdiagnosis when analyzing prenatal ultrasound data.

2021 Vol. 29　(5):　1066- [Abstract]（ 446 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

Non-invasive prenatal testing（NIPT）is used to screen fetal chromosomal aneuploidies through high-throughput sequencing technology with cell-free fetal DNA in maternal plasma, which has the advantage of high sensitivity and specificity with low false positive rate, thus, it is widely used in the screening of chromosomal aneuploidy. Compared with other chromosomal disorders, sex chromosome disorders are rare. NIPT can detect fetal sex chromosome abnormalities, and can predict the fetal outcomes, so as to reduce the incidence of birth defects. The accuracy of NIPT for screening trisomy 13, trisomy 18, or trisomy 21 is reliable, however, there are few studies on the screening fetal sex chromosome diseases by NIPT. To provide evidences for the application of NIPT for screening sex chromosome disorders, this article reviews the clinical research progress and influencing factors of NIPT for screening sex chromosome disorders.

2021 Vol. 29　(5):　1072- [Abstract]（ 381 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )